Kakata City, Margibi County (Monday, January 25, 2021)
Kakata City, Margibi County (Monday, January 25, 2021)
The LMHRA Awareness and Radio Talk-show Team arrived in Kakata City, Margibi County, on Monday morning, January 25, 2021. The Team, which comprised of six persons: three persons from the Communications Unit (Abraham Kolleh Morris, Deputy Communications Manager; Jesse Gbotoe, Communications Officer and Mark S. Chea, Communications Officer), one of Liberia’s top Comedian, (Isaac Sunday Sieh, alias (Paul Flomo)) and two technical staff to include the Technical Advisor to the Managing Director, Dr. Flomoku G. Miller and Pharmacist Humphrey B. Taylor of the Evaluation and Registration Department.
In the early morning of January 25, 2021, at about 9a.m., the two technical staff, Dr. Miller, and Pharm. Taylor, along with the Deputy Communications Manager, Mr. Abraham Kolleh Morris, Sr., visited a local radio station, Radio Margibi 103.7 FM. It is located in the county’s capital, and it is one of the most popular and widely monitored stations in that part of the country. At Radio Margibi, the Team explained the danger of street peddling and the danger on the proliferation of substandard, and falsified medicines.
The two technical staff who appeared on the radio talk-show discussed a broad spectrum of issues with regards to the following: Disabusing the minds of the public from purchasing medicines from street peddlers; the risks associated with purchasing from street peddlers; that street peddlers most of the time sell expired, falsified, substandard, or unregistered medicines.; and that those street peddlers are not trained healthcare providers, therefore they tend to misinform the public and that medicines in buckets, bags, or on market tables which may either come in direct contact with extreme temperatures of sunlight, or absorption moisture as a result of increase humidity which negatively affects the stability of these medicines, thus becoming harmful and provide bad health outcome. All of these were explained as simple as possible to get the message across.
The Role of the LMHRA in the Area of Pharmaceutical Regulations
In response, the public also had the opportunity to call and ask questions, and also raise concerns. Many callers expressed appreciation to the LMHRA for the awareness, the exceptional work being done to mitigate street peddling, and also to ensure that affordable, safe, efficacious, and effective medicines and health products are always available on the Liberian market. Some callers stated that it was also important that the LMHRA continue to engage the public with such valuable information. Others said that the LMHRA needs to step up their strategy in combatting street peddling through more public awareness and inspections.
Immediately after the radio talk show, the team took to the main streets of Kakata, where street vendors, marketers, motorcyclists, pedestrians, etc. converged in their numbers to listen to public awareness messages from the campaign team on the danger of street peddling.
The team was mainly disseminating messages against the sales, purchase and usage of medicines sold by street peddlers, and also the danger associated with the usage of these medicines.
During the campaign, awareness flyers, stickers, and T-shirts bearing similar campaign messages were distributed to the public.
Spicing up the campaign, one of Liberia’s best comedians, Paul Flomo who was a part of the campaign team, presented the campaign message in simple terms through comedy.
During the public awareness campaign on the main street of Kakata, a teenage boy who was seen selling in the open air, Oral Rehydration Salts (ORS) and powder milk was arrested by the team, and his goods confiscated.
Gbarnga City, Bong County
Bong County was very strategic to the public awareness campaign in that it is situated in the central region of Liberia. This county is one of the commercial hubs of the country, and a major center for trading falsified, substandard, expired, and unregistered medicines and health products.
The two technical staff, Dr. Miller, and Pharm. Taylor, along with the Regional Manager for Bong, Nimba, and Lofa Counties, Pharmacist Sancee G. Gray, visited a local radio station, Hot 107.9FM located in Gbarnga; a subsidiary of Hot FM 107.9FM located on Broad Street in Monrovia.
The local radio station has the widest coverage in the county and is mostly monitored by citizens. Appearing on the morning show again, the two technical persons along with the Deputy Manager for Communications continued the propagation of similar messages with regards to what was disseminated in Kakata in relations to disabusing the citizenry from doing business with street peddlers and the negative effects substandard and falsified medicines and health products poses to health outcomes.
The public also had the opportunity to call-in and make contributions. Some of the callers made mention of the poor storage conditions of some pharmaceutical premises, and the need for LMHRA to visit hard-to-reach areas to propagate these messages.
Immediately after the radio talk show; again, the entire team converged at one of the major commercial centers in Gbarnga in the market square; where many citizens came out again to listen to the messages against street peddling and the danger associated with using substandard, and falsified medicines.
The public awareness team also visited major street corners, market and communities to disseminate the awareness message. Flyers, T-shirts and stickers were also distributed to people who attended the campaign. The Technical Advisor (Dr. Miller), Pharm. Taylor and Comedian Paul Flomo were also in attendance to answer questions from the bystanders, motorcyclists and marketers and provided further clarity.
Gompa City, (Ganta City), Nimba County
Nimba County is part of the northeastern region of Liberia. It was one of the major priorities of the campaign team in that it is the second largest county in terms of population. With Ganta city, which is also called Gompa City being one of the major commercial centers in the northern region; is associated with porous border points with Guinea and the Ivory Coast. This contributes to the influx substandard and falsified medicines.
Upon entering Nimba, the awareness team conducted a consultative meeting with authorities of the county, to include the Superintendent, City Mayor of Ganta, and other stakeholders. The campaign team then converged at a central point in Gompa city, for the public awareness campaign. The team, like the other counties, propagated messages against street peddling and the danger associated with buying medicines from street vendors.
This was done via interactive discussions with people that gathered at the awareness sites. Additionally, the playing of LMHRA jingles, and discussions through comedy and simple Liberian English by Comedian Paul Flomo easily delivered the awareness message to the people of Gompa City. Similarly, awareness flyers, stickers, T-shirts with the awareness messages were also given out to the attendees.
The team also toured major street corners and communities in Ganta, further promulgating similar messages against street peddling, and the usages of falsified and substandard medicines and health products.
In Gompa city, the team also distributed flyers, stickers, and T-shirts to people in communities where the team visited. Later during the day, Dr. Miller, Technical Advisor to the Managing Director and a technical staff supporting the campaign team paid a visit to a local radio station, also a subsidiary of Hot FM 107.9, located in Gompa City, Nimba County.
Dr. Miller had a 30 minute exclusive interview with that station concerning the discussions against street peddling and also the statutory functions of the LMHRA.
However, several challenges were encountered during the campaign in the three counties:
One of the major challenges encountered was with the Public Address System (PA system). The output of the LMHRA PA system was extremely low, thus creating a serious breach in communication due to the PA system being outdated or old. This served as a major impediment to the campaign in that most people who converged at the first campaign site in Kakata city could barely understand the message. The team later negotiated to rent a new PA system so as to have the campaign objective achieved.
We were also challenged with securing popular sites to carry on the public awareness due to the team not initially meeting local county authorities in both Bong and Margibi Counties. So the public awareness was implemented on main streets, and that posed harm to bystanders due to movement of vehicles.
Owing to the messaging from the Technical Advisor, Pharmacist Taylor and Comedian Paul Flomo, the attendees clamor for more flyers, T-shirts and stickers.
While in the three counties, (Margibi, Bong, Nimba Counties), there were many recommendations generated from both the public interactions via the radio talk shows and in the field.; Recommendation were made that there should be Billboards carrying messages against street peddling erected in each of these three counties (Margibi, Bong, and Nimba) as well as other leeward counties and major towns and villages; that there should be jingles produced in the various vernaculars (dialects) and played on various local radio stations in these leeward counties; that LMHRA carry her awareness strategy to various towns and villages, for farmers and residents of these leeward counties to be safe; that the LMHRA should work towards assigning more inspectors and surveillance officers in these counties to curtail street peddling, and the confiscation of unregistered medicines and health products.;
The communication Unit recommends that, a new and sophisticated PA system be bought to ensure that messages promulgated by the awareness team be fully understood by commuters who will converge to listen to the message; that the LMHRA Facebook page be regularly maintained and boosted so as to also carry the message live every time the campaign team is on the field, that the LMHRA purchase a modern camera for the purpose of taking quality pictures and doing recordings during public awareness campaigns, that the LMHRA regularly have public awareness campaigns and radio talk shows in every part of the country so that the public will always be furnished with essential medicine information and that the hotline be made free-to-call so as to enable the citizenry access and report street peddlers and the illegal importation of pharmaceuticals through land borders.
Based on our responsibility as Communications Unit of the Liberia Medicines & Health Products Regulatory Authority (LMHRA) to project the positive image and workings of the authority; the Unit has deemed it prudent to outline the leadership and tremendous achievements of the administration of its Managing Director, Pharmacist Keturah C. Smith from October 2019 – Dec 2020.
In this light, we present a catalogue of achievements of this administration during the year under review: Regardless of the limited resources, Managing Director Smith has made significant progress in a short period of time.
Though Managing Director Smith inherited a broken system due to some political crisis, she was however innovative with the assistance of the technical team, strengthened by additional administrative staff to hit the ground running with the statutory mandate of the entity by ensuring that the country have safe, effective and quality medicines reaching the Liberian people.
To this end, here are some of the challenges and achievements of MD Smith:
- Rent for Head Office and Regional Office in Gbarnga;
- Financial liabilities for staff salaries
- Ensure health and NASSCORP insurance for employees;
- Indebtedness Local vendors;
- Lack of logistics for operations, Post Marketing Surveillance and Inspection – only 2 vehicles
- Inadequate staffing (both technical & support)
- Depleted bank accounts
- To build the status of QC lab to ISO 17025/ WHO standard
Currently, all previous financial liabilities incurred by past administration as a result of the internal wrangling has been fully liquidated during the period under review by Managing Director Smith administration.
The new LMHRA administration inherited a financially broken institution. Especially with the employment of new staff members, thus, meeting the needs of staff salaries and other benefits were the greatest challenge, considering that fees were not being collected as under normal administrative circumstances.
In the same vain, there was a need for total restructuring of the entity’s revenue collection structures, including reassigning of key staff.
Upon Pharmacist Smith’s ascendancy, like all other public institutions, COVID-19 also had a serious toll on the LMHRA’s resource mobilization efforts. Hence, registration of medicines and health products, and other revenue generation areas were at the lowest pace. Accordingly, a very meticulous spending and administrative regime were immediately put into place for operations of the Authority under the ongoing global pandemic.
However, these challenges did not come without significant achievements:
- Since the establishment of the LMHRA by an Act of the Legislation in 2010, some employees of the entity were being paid incentive while few were paid both incentive and GOL salary;
Nevertheless, we are delighted to report that the Government of Liberia, through lengthy negotiation of the administration of the LMHRA and the Ministry of Finance and Development Planning (MFDP), has absorbed about 99.9% of staff salaries, including the newly recruited staff;
- Within a year, under the instrumentality of the Managing Director, through the Board of Directors, the LMHRA has constructed a mini-Office Building currently in use as Quality Control Laboratory in Careysburg, Montserrado County.
- The MD in short a while, also ensured robust inspection by the Inspectorate Department of LMHRA for all pharmacies, medicine stores, pharmaceutical importers warehouses as well as health facilities in and outside of Montserrado.
- MD Smith as head of the entity, also ensured that every department or unit of the LMHRA network and collaborate to ensure the core objectives of the institution is achieved.
- As it is common knowledge, since the establishment of the LMHRA for the sole purpose of ensuring that quality, efficacious and safe medicines and health products are regulated; under MD Smith’s stewardship, the Communications Unit in consonance with the Medicines Information Unit, were able to produce and is currently airing several jingles on street peddling, medicines registration, adverse drug reaction and as well as the discouragement of the citizenry on the purchasing of fake, expired and substandard medicines and health products from street peddlers (Black Baggers) on several radio stations in Monrovia and around the country.
- As was in the past, little or nothing was heard of or known by the public of the workings of the LMHRA; but under this illustrious youthful Managing Director and her technicians as well as administrative support staff, there has been several radio and/or media appearances of the MD Smith and other Technical Staffs and newspaper publications highlighting the achievements, prospects and challenges of the entity, thus so far giving the general public a broader understanding of the workings of LMHRA.
- MD Smith leadership has also ensured that premier is placed on the sensitization of the public about the harm of purchasing from street peddlers and counterfeit medicines and health products poses to the citizenry of Liberia.
- In adherence to the Public Procurement Law as well as the Public Financial Management Law, Madam Smith, under her administration mandated that all procurement and financial transactions of the LMHRA are in strict adherence to the PPCC and PFM Laws of Liberia.
- MD has also ensured full collaboration and networking with other key ministries agencies and partners both in the health and Governmental sectors. Thus, leading to the Liberia Revenue Authority (LRA) confiscating and turning over to the LMHRA on several occasions, expired, sub-standard and counterfeit medicines from two of Liberia’s land border points.
- The LMHRA Boss through her leadership spearheaded a 5-day technical and administrative retreat that led to the production of various Standard Operating Procedures and Departmental manual for the smooth running of the authority.
- Madam Smith leadership was also instrumental in the establishment for the first time; a 21st century website as well as a social media platform (Facebook) page. She has likewise maintained a very cordial relation with every staffer and thus making her office accessible as well as ensure senior and general staff meeting regularly.
- The LMHRA under Madam Smith has also established two hotlines service for the public to make inquiries and also report the smuggling, peddling and sale of counterfeit medicines and health products.
- Signed a memorandum of understanding (MOU) in March 2020 with Ghana FDA for third party testing of medicines and health products
- In an effort to strengthen the Authority, Managing Director Smith also established Programs & Planning, , with the role and responsibilities: to lead the resource mobilization efforts of the LMHRA and manage donor funds; design, monitor and evaluate programs, projects and implementation of work plan; lead and keep records of approved development plans (including construction works), projects and budgets of the Authority and their execution time schedule as specified; help support preparation of annual budgets and rolling plans in collaboration with Administration and the Finance Department.
- For the first time the entity also secured security for head office and as well secured a private security firm for her new mini quality control lab in Careysburg, Montserrado County.
- For further sensitization and information dissemination purposes and as a way to further expose the working of the Authority, the administration the LMHRA also ensure the erection of five by eight meter billboards, along the Congo Town, VAMOMA House, Tubman Blvd., Robert International Airport and Freeport vicinities to acquaint the general public about the LMHRA and its workings.
- Madam Smith has placed premier on the issue of employees’ empowerment thus ensuring that all employees of the authority having access to health and National Social Security and Welfare Corporation insurance schemes.
- During the period under review, the following trainings/seminars/workshops were attended by LMHRA staff:
- Foreign: Several staff attended foreign trainings and meetings during the period under review, including:
- The MD attendance of the 7th Steering Committee Meeting of the West Africa Medicines Regulatory Harmonization (WA-MRH) Project of the West Africa Health Organization (WAHO) in Dakar, Senegal this year with the following terms of reference:Providing strategic and policy directionApproving technical documents
- Quality Management System training in Ghana by three (3) staff members, drawn from the Lab, Internal Audit & Office of the MD. Attendance of 3rd Edition of the African Medicines Quality Forum in Nigeria from February 24 – 28, 2020 by the Quality Control Manager. Attendance of the Annual Meeting of the National Medicines Quality Control Laboratories \in the Ivory Coast in November of 2019 by the Quality Control Manager and his deputy.
- Local: Several local trainings were conducted since her appointment, including:
- Quality Management Training for one week in March of 2020;
- GHPP assessment of Marketing Authorization System, leading to capacity building in February 2020;
- Staff Retreat: A staff retreat, with the main objective of reviewing guidelines and other administrative policies and documents, was held from April 1 – 7, 2020. The final report, along with reviewed and updated guidelines, Standard Operating Procedures (SOPs) and other relevant documents were shared with Board for their perusal and subsequent approval.
Recently, MD Smith along with other senior staff from the Inspectorate and Registration and Evaluation Departments as well as senior staff from USP-Liberia, travelled to Accra, Ghana for a study tour of the Ghanaian Food and Drug Administration (FDA) and approve on our system in Liberia.
Decentralization of Regulatory Activities:
Her able leadership has for the first time in the history of the entity established offices at the National Port Authority (NPA) and the Robert International Airport (RIA) to streamline medicines and health products and as well confiscate illegal, expired counterfeit and banned medications or health products from entering the local market.
As the LMHRA continue to find avenues for strengthening of the LMHRA for full execution of its mandate, MD Smith also ensure the securing of office spaces for decentralization of regulatory activities by:
- The establishment of Ports and Border Services Unit, thus leading to the opening of offices at the Freeport of Monrovia and Robert International Airport (RIA) with plans to extend next year to other border points including (Bo-Waterside in Grand Cape Mount County, Ganta-Guinea Border in Nimba); with the already existing regional office in Gbarnga, Bong County. Several staff have already been deployed at these various regional and port offices and operations smoothly ongoing.
- Thirteen (13) staff have been assigned at the RIA after holding several meetings with the RIA Authority for permanent posting of LMHRA staff;
- There has been a rigorous restructuring of the Regional Office in Gbarnga – with posting of additional staff with logistical support (procurement of motorbikes) to strengthened and enforced regulatory activities
- Construction Works
In order to further improve service rendered by the LMHRA, MD Smith organized a one-day stakeholder roundtable pharmaceutical and health sector meeting with various players in the health sector in the country to discuss the construction of the quality control lab.
- MD Smith through her lobbying skills and collaboration with other sector of Government, was instrumental in securing a two-storey fully furnished office building for the authority up Mamba Point, in Central Monrovia, with rent being fully covered by the Government of Liberia.
- The illustrious and youthful LMHRA Managing Director, upon her ascendency met a logistically-challenge authority, leading to limited Post Market Surveillance (PMS) inspection due to the lack of vehicle or the entity having only old two vehicles. Through her innovation and leadership skill, Madam Smith through Global Fund, was able to acquire two brand new High-top Land Cruiser Jeeps with funding from Global Fund; one 18-seated bus for staff of the Quality Control Lab and another vehicle for the office of the Managing Director.
- Pharmacist Smith through her lobbying power, is expected to acquire from the World Bank, reagents, chemical and equipment for the Quality Control Laboratory. Through the Madam leadership, the United States Pharmacopeia Convention (USP), Promoting the Quality of Medicines Plus (USP-PQM+) is expected to procure additional equipment, reagents and chemical for the QC Lab.
- The LMHRA through fees collected over the years, has also procured additional equipment, reagents and chemical for the QC Lab in order to continue visual testing and physiochemical analysis.
- Though in 2017, QC Lab was gutted by fire thus leading to only visual inspection being conducted by the LMHRA, the lab was later transferred to another location at Sophie Community where the lab graduated from just visual inspection to both visual inspection and physiochemical analysis. After few months in office again. In 2019, MD Smith ensure the laboratory moved to its current location in Kings Farm, Careysburg, Montserrado County; where a full visual inspection and physiochemical analysis are being conducted.
- Currently, a fully fenced and furnished mini QC Lab estimated worth of US$165,000.00 has been constructed and fully operationalized; with plans for official dedication His Excellency President Dr. George Manneh Weah Sr., in early 2021.
- Also, there is a Memorandum of Understanding with the Global Fund for the construction of US$4.3million dollars state-of-the-art International Organization for Standardization (ISO 17025) and World Health Organization (WHO) standard Quality Control Lab.
The Liberian Medicines &Health Products Regulatory Authority (LMHRA) is commending the Liberia Revenue Authority (LRA) for the level of collaboration in recent time especially in helping combating the illicit flow of pharmaceutical products in the country.
The LRA in recent has been instrumental in confiscating thousands of dollars illegal pharmaceutical products smuggled in the country by some unscrupulous individuals.
It can be recalled that the Customs Department of the LRA turned over to the LMHRA huge consignment of pharmaceutical products illegally imported in Liberia from Guinea, by an individual identified as Abdulla Kamara.
The pharmaceutical products, according to LRA officials were intercepted by Customs Anti-Smuggling Officers along the Somalia Drive following a tip-off.
According to a Customs investigation report, the assorted pharmaceutical products were smuggled into the country through the Guinea, Ganta Border.
The report further stated that the assorted medicines were concealed in twelve (12) Jomo size boxes under other goods being legally imported in the country.
The assorted medicines or pharmaceutical products included: Pain killer, Multi-Vitamin, Cold Caps, and Amoxicillin among others and is valued at over Five Thousand United States Dollars (US$5,000.00).
Presenting the confiscated medicines to the LMHRA, LRA Manager of Anti-Smuggling& Investigation Unit (ASIU), Masu Fahnbulleh noted that the LRA will remain steadfast and engaged in ensuring effective border security and protection under its border management strategy.
He disclosed that the importer identified as Abdullai Kamara without permit imported and smuggled the assorted medicines into Liberia.
Receiving confiscated products on behalf of the LMHRA, the Deputy Inspector-General of the LMHRA, Dr. Thomas Kokulo, thanked the LRA for the seizure and described the collaboration between the two government agencies as vital in curbing the illegal importation of medicines and other harmful products into the country.
The seizure is part of an LRA on-going regional customs enforcement operation under the auspices of the World Customs Organization (WCO) code name: “Cripharm V” targeted at combating the illicit flow of pharmaceutical products.
Also speaking upon receiving the illegal pharmaceuticals at the head offices of the LMHRA, the Inspector General of the LMHRA, Pharmacist Teedoh Beyslow, frowned on illegal importation of pharmaceuticals, and health products and medical devices in the country without the expressed approval of the LMHRA; especially through land borders and under harsh conditions.
He vowed to ensure those caught in smuggling medicines, and health products and medical devices in Liberia, to be drastically dealt with in accordance with the law and regulations governing the entity.
Pharmacist Beyslow also disclosed plans in the coming days, to turn the culprit to the Independent Hearing Board of the LMHRA for investigation and as after which findings, they authority will seek Court order to have the confiscated medicines (pharmaceuticals)burned (incinerated).
He also thanked the Liberia Revenue Authority for the continual cooperation and mutual respect existing between the two entities and further urged the LRA to remain more vigilant in ensuring that those involved in the smuggling of medicines, and health products and medical devices are brought to book and punished in accordance with the laws of the country. In April of 2020, the LRA Customs Department again turned over to the LMHRA, huge consignment of pharmaceuticals illegally imported through the Liberian-Sierra Leonean border post at Bo Waterside in Grand Cape Mount County.
The Managing Director of the Liberia Medicines and Health Products Regulatory Authority (LMHRA), Pharm. Keturah C. Smith, is calling on the Government and international partners to lend more support to the institution; especially the improvement of the testing laboratory.
Appearing as guest on the Freedom Morning Ride, on Freedom FM in Monrovia, the LMHRA MD said the major challenge currently confronting the institution is the improvement of the lab as well as the provision of more reagents.
She also decried the issue of the lack of manpower and logistics as some of the core challenges confronting the LMHRA. Managing Director Smith further recounted the lack of staff at the major border points of the country.
However, the LMHRA boss attributed the many challenges affecting the entity to the lack of adequate funding. However, Madam Smith noted that despite these challenges, the entity is still reinforcing rigorous inspections of all medicines and health products brought in the country.
She also noted that currently, LMHRA only has two vehicles that are being used for inspection; something she noted is insufficient to conduct nationwide inspection.
Madam Smith vowed to ensure that the capacities of the inspectors are built and their integrity is at an all-time high so that they don’t compromised.
MD Smith however argued that the lab is functioning and they are carrying on visual testing of medicines and health products brought in the country.
However, the LMHRA has further disclosed that the institution is working with international partners including Global Fund to augment the lab and get more reagents (WHO), the World Bank and the United States Aid for International Development (USAID).
MD Smith vowed to ensure that she makes the LMHRA laboratory upgraded up to international standard like other institutions in the region.
Madam Smith said confiscating these expired medicines and products from the market is not for witch-hunting or to extort money from business people, but to streamline and ensure medicines, cosmetics and health products brought in the country are safe, efficacious and quality assured for the public.
According to her, she intent to build the human capacity of her employees and also ensure the lab is rehabilitated by the end of this year.
Madam Smith is however calling on the public to avoid buying medicines and health products from street peddlers and unrecognized institutions.
She said the LMHRA needs over US$1,000,000 to revamp the lab and also relocate the laboratory into an area that is suitable for both testing and waste disposal.
Appearing also with the LMHRA boss, the Pharmaceutical Information Officer, Juwe Kercula, vowed to ensure adequate information, community awareness, and media engagements are carried out so as to ensure people avoid purchasing fake medicines and health products.
He noted that the LMHRA generates information from the public and the various departments especially the inspectorate department to inform their decision for raid fake drugs and harmful health products on the market.
Kercula indicated that once the LMHRA discovers expired products, the entity carried on awareness and published these expired medicines and health products discovered from importers, wholesalers, retailers and street peddlers.
He said owing to the fact that there isn’t stronger law on the book to enforce those apprehended; the LMHRA imposed huge fines on would-be perpetrators so as to curtail such negative vices.
“Like my MD said, health is wealth and life, so we are calling on the public to avoid buying medicines from unrecognized persons and stores because we cannot traced these people in the case of any harm to your body,” Kercula explained.
Meanwhile, several persons who called on the phone-in show urged the Executive and the Legislature to allocate in the next budget year, adequate funding for the LMHRA.
Also calling on the program, several employees of the LMHRA lauded the MD for her tremendous development at the entity over a rather short period of time.
The employees also called on President George Manneh Weah and the Legislature to buttress the effort of MD Smith and her team in order to make the entity viable and comparable to others in the region.
In an effort to discourage citizens from purchasing fake, substandard and expired medicines and health products on the local market, the Liberia Medicines and Health Products Regulatory Authority (LMHRA) has commenced a five-day awareness campaign aimed at discouraging citizens from purchasing fake, substandard and expired medicines and health products on the local market.
The campaign was launched on Thursday, June 25, 2020 beginning at the Duala Market on the Bushrod Island, outside Monrovia. Speaking during the launch of the awareness, the Managing Director of the LMHRA, Keturah C. Smith, disclosed that the exercise was intended to help guarantee the health of Liberians and other foreign residents in the country.
The initiative, supported by Global Fund, benefitted densely populated communities including Red-light, West Point Water Side market, Old Road market, Barnersville, Somalia Drive, with Duala market being the starting point of the awareness.
She noted that citizens should desist from buying medicines from street peddlers, most of whom, did not acquire any knowledge on what they sell to citizens in the market places, communities and other areas.
She maintained that Liberians would be endangering their health if they continued to purchase “unaccounted” fake and expired medicines and health products being clandestinely brought into the country through land border points, and criminally sold on the Liberian market.
Pharmacist Smith pointed out that those selling fake and expired medicines in buckets are in the constant habit of exaggerating the positive effect of their products, and as such, consumers should not be carried away by their dubious acts.
The LMHRA boss urged citizens to always purchase their medicines from the pharmacies or drug stores instead of in the streets or on the sidewalks. According to her, the health condition of citizens would turn from bad to worse if fake and substandard medicines are purchased from the sidewalks and taken.
She disclosed that the latest campaign launched by the LMHRA is in no way intended to take Liberians out of business, but it is intended to ensure that citizens remain healthy to meaningfully contribute their quotas to Liberia’s rebuilding process by adhering to the necessary health regulation and avoid selling expired or fake medicines on the streets”.
“We need to help ourselves to push things forward. We have to be healthy to help our country and Government. Tell your family members not to buy medicines from plastic bags or from buckets”.
Making remarks and performing the official launch, the Chairman of the House Committee on Health, Nimba County Representative Joseph Somwarbi said Liberians should not allow people to play with their health by purchasing fake and expired drugs on the local market.
“People sell medicines in Liberia for two purposes; to make money and to make sure that medicines are available to our people but they don’t understand one thing. Medicines are like kitchen knives which our mothers and sister use to cook our foods and make us grow well; but they advise that we must not allow children to play with it due to the danger associated with the knives,” the Chairman of the House Committee on Health noted.
The Nimba County lawmaker added that most of these street peddlers selling medicines in buckets and black bags, do not know the effect of those health products they sell.
“Medications that are kept in heat or sunlight have lost their ability to cure any illness. Health products such as scorpion rub, triple action and kung-fu rub, among others, are secretly brought into the country from neighboring countries without being tested at the LMHRA’s laboratory.
He continued: “They put the medicines in bags, tie them up, and place them in a car or truck. Imagine the heat the drugs are being placed under; as a result, they lose their strength.”
Representative Somwarbi, however, pledged his commitment and support to help eradicate the sale of fake, expired and substandard medicines and health products on the Liberian market.
The five-day public awareness campaign carried on in several market areas was characterized by live drama performance from the Paul Flomo Comedy group, distribution of fliers, bumper sticker as well as live radio appearances and jingle productions for airing.
The Liberia Revenue Authority (LRA) through its Customs Department has seized a huge quantity of substandard pharmaceutical products smuggled into the country.
The substandard pharmaceutical products including Vitamin C, Vitamin B-2, Cold Caps and Amoxicillin among others, were concealed in 18-boxes on-board three Guinean commercial buses.
The medicines, valued at US$10,000, were discovered by officers of the LRA Anti-Smuggling & Investigation Unit (ASIU) after a thorough search of the Guinean commercial buses that brought the products to Liberia. The buses were intercepted following a tip-off from Customs informant.
The medicines were illegally imported into Liberia through the Liberian-Sierra Leonean border post at Bo Waterside in Grand Cape Mount County by four individuals who are not licensed to import medicines, the LRA says.
The seizure is part of an on-going regional customs enforcement operation under the auspices of the World Customs Organization (WCO) code name “Cripharm V” which is targeted at combating the illicit flow of pharmaceutical products.
Meanwhile, the LRA has turned over the seized medicines to the Liberia Medicines and Health Products Regulatory Authority (LMHRA) for onward inter-agency coordination and action.
Speaking during the presentation of the products to the LMHRA, Assistant LRA Commissioner for Customs Enforcement Blamo Kofa said the Authority remains committed to facilitating legitimate trade while ensuring the protection of the people of Liberia.
He said even in the midst of the coronavirus pandemic, the LRA remains vigilant in carrying outs its mandate relative to cross border trade and ensuring social protection for the people of Liberia.
The Managing Director of the LMHRA Keturah Smith thanked the LRA for the seizure, describing it as laudable.
She called for more collaboration between governmental agencies with the aim to ensure the protection of the health of citizens by working together to eliminate illegal importation of medicines and other harmful products into the country.
In a related development, the LRA Anti-Smuggling Unit recently intercepted a 20-foot Container with Hazardous Chemical (Sulphuric Acid) imported from the Netherlands without permit and in violation of Liberia General Business Law and the Environmental Protection and Management Law.
The March 28, 2020 response and seizure were triggered by an alert from Customs Risk Management Unit and is also part of an on-going Customs regional enforcement operations under the auspices of the World Customs Organization (WCO) code name Alamba 2020, targeted at combating the illicit flow of precursor chemicals used to produce Improved Explosive Devices (IED’s).
Imported by York Trading Inc, the dangerous chemical was turned over the Environmental Protection Agency (EP
In an effort to boost productivity at the Liberia Medicines and Health Products Regulatory Authority (LMHRA), the Board of Directors in August 2020 conducted a two-day strategic workshop that seek to improve the workings of the authority thereby boosting productivity.
According to the Chairman of the Board of Directors, Professor, Hasipha Tarpeh, the objective of the two-day event was to enable members of the board and stakeholders in the sector demonstrate good knowledge of the function of the board and the authority.
Professor Tarpeh said in order for the authority to survive and move forward, there is a need for members of the board to distinguish the roles and responsibility of LMHRA; understand the mandate of the authority and that of the board as well as the implementation of the Act of 2010 creating the LMHRA.
The Chairman of the LMHRA Board stressed that during the two days workshop, agreed to design means to craft a regulation that will address issues in the Act that are impeding the progress of the entity.
Chairman Tarpeh called for high degree of integrity, advocacy, coordination and cooperation between and among key players in the health sector.
According to him, the purpose for which the board was established or setup is to ensure the monitoring and evaluation of the day to day activities of the authority.
Prof. Tarpeh further argued that almost all the members of the board are new; it was expedient that they converged to understand the Act establishing the LMHRA.
He also maintained that the meeting was also important for the board to understand the constraint the authority is confronted with in order to support the work of the LMHRA.
He disclosed of plans to by the board to come up with a resolution that seek to address some hurdles confronting the smooth running of the authority.
In bid to sustainably strengthen pharmaceuticals and medical product quality assurance systems in Liberia, the Liberia Medicines and Health Products Regulatory Authority (LMHRA) in collaboration with the United States Pharmacopeia Convention (USP), promoting the Quality of Medicines Plus, on December 18, 2020, established a Post Market Surveillance Technical Working Group (PMS-TWG) for Liberia.
The goal of the PMS-TWG is to ensure the coordination of the relevant stakeholders in the building of PMS systems and periodic planning of PMS activities to assure the quality of medical products in the country.
The PMS-TWG seeks to ensure the building of a robust risk-based post-market surveillance systems for medicines that are found on the Liberian market.
Addressing the official opening of the one-day PMS-TWG Stakeholders’ meeting held at the Mamba Point Hotel in Monrovia; LMHRA Managing Director, Pharmacist Keturah Smith, lauded the participants for gracing such auspicious occasion.
She informed the gathering that with the setting up of the PMS-TWG, it will ensure that there is strategies and approaches to ensure substandard and counterfeit medicines are minimized on the market.
According to her, in this age and time, individuals should not be dying because of the proliferation of fake, substandard and falsified medicines and health products.
So with the establishment of the PMS-TWG, Managing Director Smith indicated that the LMHRA looks forward to a successful collaboration with the TWG to ensure substandard and falsified medicines are raided of the Liberian society.
She encouraged every well-meaning Liberian to be on the alert by reporting those in the habit of infesting the market with substandard and falsified medicines in the country.
Making two virtual presentations, the Director of USP-Ghana, Kwasi Poku Boateng, indicated that Promoting the Quality of Medicines Plus (PQM+) Program is a five-year cooperative agreement between USAID and the U.S. Pharmacopeia Convention (USP) to sustainably strengthen medical product quality assurance systems in low-and middle-income countries.
He further stressed that the program is geared to improving medical product quality through systems strengthening approaches and the application of international quality assurance standards across the pharmaceutical system.
According to Director Boateng, by sharing scientific expertise and providing technical support and leadership, PQM+ is helping to create a resilient and robust local health systems that addresses diseases such as HIV/AIDS, tuberculosis, malaria, and neglected tropical diseases, as well as improve maternal, newborn, and child health.
Director Boateng recalled that in 2010, with technical support from the predecessor promoting the Quality of Medicines (PQM) Program, the Government of Liberia established the Liberia Medicines and Health Products Regulatory Authority (LMHRA) through an Act of Legislation.
He said from 2013 to 2019, PQM helped NMCP and LMHRA conduct six rounds of monitoring of the quality of antimalarial medicines where (over 600 antimalarial medicines samples were collected and tested).
Boateng further disclosed that building on the work conducted under PQM+, USP-Liberia will work with the LMHRA and other stakeholders to adopt a risk-based sustainable approach to post-marketing surveillance.
According to him, his institution in consonance with the LMHRA, will ensure an effective, risk-based PMS programs that will optimize the use of resources and promote sustainability so that post market surveillance is integrated and implemented as a core regulatory function.
Quoting Dr. Vladimir Lepakhin: Director Boateng noted that: “Dying from a disease is sometimes unavoidable, but dying from a medicine is unacceptable.”
The Director of USP-Ghana also recalled that in September 2019, the USAID/Liberia Mission invited the PQM+ program to engage in efforts to strengthen Liberia’s medicine quality assurance systems which led to a scoping visit by members of the PQM+ leadership team in December 2019 to understand the current state of medicine quality assurance systems and mission priorities. Based on the findings of a scoping visit, Boateng asserted that the following where undertaken: a rapid assessment of pharmaceutical market to identify threats to quality-assured medicines in Liberia; an analysis of select LMHRA functions and fees; an in-depth assessment of laboratory needs to allow basic functionality and developed a plan for specific activities to be implemented.
Accordingly, Boateng said moving from a sporadic medicines quality monitoring activities toward robust risk-based-PMS programs is critical for a country to ensure the quality of medicines and medical products.
He also maintained that effective risk-based PMS programs will also optimize the use of resources and as well support countries in transitioning from donor-supported surveys to locally funded and sustainable PMS programs that are integrated and implemented as a core regulatory function.
In order to achieve these initiatives, Director Boateng outlined the need for regulatory agencies to have the legal mandate and scope to perform PMS; have sound PMS governance structure, which is independent, accountable, transparent, responsive, and equitable; ensure financial resources allocated to implement effective PMS program; recruit/utilize personnel with requisite training and expertise to undertake PMS activities; plan and coordinate PMS activities with relevant stakeholders, and develop an implementation plan with clearly defined roles and responsibilities and as well conduct a risk-based sampling methods for areas and medicines that are most vulnerable and represent the greatest risk to public health.
The PMS-TWG will provide technical inputs, develop guidance documents and protocols for PMS activities in Liberia; determine priorities and sampling plans for annual PMS rounds; develop and disseminate PMS reports in a timely and coordinated manner; monitor regulatory actions taken as a results of PMS findings; monitor progress on implementation of PMS activities in Liberia; advocate for funding for annual PMS activities and provide quality-related recommendations to the Procurement Division of the Ministry of Health.
Members of the newly established PMS-TWG include: the LMHRA as Head of Secretariat; Health Programs; the Ministry of Health (MoH) Disease Control Programs (NACP, NMCP, NLTP, EPI, County referral Hospital, CHT, SCMU etc.); Central Medicine Store (CMS); Global Fund, (GF) and World Health Organization (WHO), UNICEF, UNFPA, UNDP, USAID, PQM+; and the Liberia National Police.
Others organizations also forming part of the PMS-TWG are: Liberia Drugs Enforcement Agency; Liberia Revenue Authority (Custom), Liberia Custom Brokers Association; Ministry of Commerce; Liberia Marketing Association; Pharmaceutical Importers’ and wholesalers’ Association; Ministry of Finance & Development Planning and the Environmental Protection Agency (EPA).
Meanwhile, at the close of the meeting, Pharmacist, Alex Korkolea, Director for Operations, Central Medical Store (CMS), as Chairman and Madam Tabadeh Kollah of the National Malaria Control Program (NMCP), as Vice Chairperson; with a mandate to serve for a term of three (3) years.
For their part, the leadership and members of the newly-established PMS-TWG pledged their unwavering support and collaboration to the monitoring and making informed policy and governance decision of Liberia’s PMS system.
PMS-TWG vowed to work with the LMHRA, USP-Liberia to ensure that the objective for which the PMS-TWG was established is fully met.
The Liberia Medicines & Health Products Regulatory Authority (LMHRA) and several stakeholders of the LMHRA held a one-day meeting aimed at brainstorming on strategy and galvanizing resources to build an Internationally Certified Quality Control Laboratory (QCL) to ensure the general public has access to safe, effective and quality medicines.
Addressing the LMHRA stakeholders’ meeting with several counterparts in Monrovia, LMHRA’s Managing Director, Pharmacist Keturah C. Smith, in a PowerPoint presentation noted that if citizens and inhabitants of the country must have optimal health outcome, there is a need for the QCL of the authority to be internationally accepted and accredited by the International Organization for Standardization (ISO).
The meeting was held at the Mamba Point Hotel under the theme: “Our Vision for Ensuring the Quality of Medicines & Health Products-the Quality Control Laboratory in Perspective.”
Managing Director Smith said the meeting was called to ensure that the LMHRA and its partners brainstormed on ways and means that seek to improve the laboratory and the services the LMHRA provides.
“Therefore, LMHRA envisages a modern, state-of-the-art laboratory facility that is internationally accepted and accredited by the International Organization for Standardization (ISO 17025:2017),” Pharmacist Smith emphasized.
According to her, some of the challenges of the entity include the country’s porous borders, recruitment retention certain technical staff (ex. Biotechnologists) as well as proliferation of substandard and falsified medicines and health products through the pharmaceutical supply chain.
She also outlined the lack or limited supply of reagents to the lab, the lack of inspectors at various border points, as well as logistics.
MD Smith pointed out that the QCL cannot achieve optimal quality testing if it is still operating in a small space and at a low scale, as several testing equipment are down or need recalibration.
Therefore, Pharmacist Smith expressed the need to ensuring that there is a need for robust monitoring of medicines quality at all levels of the supply chain as well as the improvement of quality assurance (QA) & Quality Control (QC) activities through a quality control laboratory that provides reliable testing of all medicines and health products.
In 2010, the LMHRA Act was passed by the Legislature and approved by the President of Liberia seeking to ensure that the law provides for quality assurance through laboratory testing. Hence, a 3-year strategic plan was developed in 2013 providing for a 4-unit (physio-chemical, medical device, microbiology and cosmetics) QC laboratory.
However, the LMHRA boss lamented that up to 2011, the QC Lab operated at a very low capacity with only a maximum of 3 staff performing basic analysis of medicines via minilab, thin-layer chromatography and color reaction. Currently, the laboratory operates with twenty-two (22) staff.
Throughout the years from 2011 up to 2017, before the lab was gutted by fire, Pharmacist Smith noted that there was a progressive movement toward accreditation, increment of work force, initiation of quality management system, enhancing staff capacity through training, expansion of testing scope with the use of advanced analytical equipment such as HPLC, UV Spectrophotometer, Dissolution tester, Disintegration tester with support from the United States of America International Development (USAID) through the program Promoting Quality of Medicines (PQM) and implemented by United States Pharmacopoeia (USP). Support was also provided by the West African Health Organization (WAHO), Global Fund and the Government of Liberia.
She revealed that another noteworthy achievement of the LMHRA was the acquisition of 4 acres of land in King’s Farm, Careysburg, on the Monrovia–Kakata highway that a temporary lab facility is being built and currently nearing completion and poised to relocate the Lab in October this year.
The LMHRA Boss maintained that some of the challenges in running an effective QC Lab include: recruitment and retention of qualified staff; capacity building; constant supply of electricity and clean running water; laboratory infrastructure – adequate space; laboratory commodities (equipment and their accessories, glass wares, consumables such as chemicals & reagents, reference materials including reference books, reference standards and calibration kits).
Accordingly, she pointed out that the LMHRA’s strategy is to utilize the demonstrated opportunities which have been provided by major stakeholders to include. Additionally, she stated that, the Political commitment to support medicines regulation has been demonstrated by the enactment of the LMHRA 2010 Act and the budgetary support of the Government of Liberia. Moreover, Pharmacist Smith said, the willingness of development partners to collaborate with LMHRA in minimizing the challenges LMHRA is faced with, if not eliminating them. These, which include, an internationally certified and fully equipped functioning QC lab, logistics (mainly vehicles, amongst others) for inspection and Post Market Surveillance (PMS), trainings, recruitment and retention of staff, etc.
Pharmacist Smith further maintained that in order to provide expanded service delivery, reduce the negative economic and social impact of paying for substandard and falsified medications for the treatment of diseases, stakeholders’ collaboration and support could not be over emphasized so as to and improve medicines safety, quality and proper information dissemination.
She noted that if, the LMHRA QC laboratory is WHO-prequalified or ISO 17025-accredited, and then it can be used to perform QC testing of grant-funded products and increased confidence in the quality of work performed by LMHRA QC Laboratory.
Stakeholders at the one-day event however lauded the Authority for the meeting as well as the tremendous works ongoing at the institution. Some of the stakeholders who attended the meeting were representatives of: WHO, the Global Fund, Chinese Medical Team, United Nations Industrial Development Organization (UNIDO), USP/PQM+, Supply Chain Management Unit of the Ministry of Health (SCMU-MOH), MSF France, and USAID.
Meanwhile, the stakeholders have proffered several significant recommendations (key action points) to the authority, which Managing Director Smith and team are taking under due consideration and working towards, aimed at ensuring the country has a quality-control, as well as, quality-assured medicines and health products.